Nationwide survey of alcohol screening and brief intervention practices at US Level I trauma centers.
BACKGROUND
In 2007, the American College of Surgeons (ACS) Committee on Trauma implemented a requirement that Level I trauma centers must have a mechanism to identify patients who are problem drinkers and the capacity to provide an intervention for patients who screen positive. Although the landmark alcohol screening and brief intervention (SBI) mandate is anticipated to impact trauma practice nationwide, a literature review revealed no studies that have systematically documented SBI practice pre-ACS requirement.


METHODS
Trauma programs at all US Level I trauma centers were contacted and asked to complete a survey about pre-ACS requirement trauma center SBI practice.


RESULTS
One hundred forty-eight of 204 (73%) Level I trauma centers responded to the survey. More than 70% of responding centers routinely used laboratory tests (eg, blood alcohol concentration) to screen patients for alcohol and 39% routinely used a screening question or standardized screening instrument. Screen-positive patients received a formal alcohol consult or had an informal alcohol discussion with staff members approximately 25% of the time.


CONCLUSIONS
The investigation observed marked variability across Level I centers in the percentage of patients screened and in the nature and extent of intervention delivery in screen-positive patients. In the wake of the ACS Committee on Trauma requirement, future research could systematically implement and evaluate training in the delivery of evidence-based alcohol interventions and training in development of trauma center organizational capacity for sustained delivery of SBI.
Terrell
Francine
F
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98104, USA.
Zatzick
Douglas F
DF
Jurkovich
Gregory J
GJ
Rivara
Frederick P
FP
Donovan
Dennis M
DM
Dunn
Christopher W
CW
Schermer
Carol
C
Meredith
Jay Wayne
JW
Gentilello
Larry M
LM
D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D014193:Trauma Centers; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy